I Can See Health

From morning to now, the emergency department has given the patient at least three diuretics (furosemide)!

However, the patient did not pass a drop of urine!

This made everyone present stunned.

Lu Chen and Xiao Shikang, who were about to leave, stopped at this time.

"Let's go see the old man with 12 beds again!" Xiao Shikang said in a deep voice, he was really worried.

So, Lu Chen, Xiao Shikang and Dr. Fan Jian from the emergency department came to the bedside of bed 12.

…

Come to the bedside.

Lu Chen immediately squatted down and checked the patient's urine bag.

Sure enough, there was only 300ml of liquid in the urine bag. .

"What's going on?" Fan Jian murmured to himself. He examined the patient again, "Is it acute renal failure?"

Xiao Shikang shook his head, "It doesn't look like it! The patient's urine output in the past two days was normal, but it has been less since last night. In addition, although the patient's serum creatinine value has increased, it has not reached the level of severe renal failure. The point.”

If it’s not kidney failure, what could it be?

Lu Chen stood beside the hospital bed, continuing to check the patient's medical records, and fell into deep thought.

"Old Fan, tell me, am I suffering from heart failure?" Fan Jian said suddenly.

"It's not heart failure?" Xiao Shikang asked doubtfully, "Then what do you think it is?"

"For example, pulmonary embolism?" Fan Jian whispered.

The patient has been bedridden for several years, and the blood flow in the blood vessels of the lower limbs will definitely not be very good, and it is easy to form thrombosis.

Once the thrombus breaks off, it may flow into the pulmonary artery, causing pulmonary embolism, leading to symptoms such as asthma and hypoxia.

Xiao Shikang frowned and said: "What you said makes sense, but even if it is a pulmonary embolism, when the patient's blood pressure is normal and the blood volume is sufficient, he should still urinate when taking diuretics, right?"

Fan Jian scratched his head and said, "That's right."

At this time, the patient's family couldn't help but ask: "Doctor, he is still wheezing and it has not been relieved. He seems to be getting worse. What's going on? Does it matter?"

It can be seen that the patient's family members are very scared, and their lips are trembling while speaking.

"The old man has never suffered from heart failure before! Why is it so serious this time?"

Lu Chen frowned when he heard this. This patient has never suffered from heart failure?

He looked at the old man, who was lying on the bed, unable to express himself due to aphasia and Alzheimer's disease.

Isn’t it really heart failure?

Just as Lu Chen's mind was running rapidly, a prompt suddenly popped up on the system panel.

"Congratulations on your breakthrough in clinical thinking ability!"

At the same time, countless diagnoses and differential diagnoses suddenly flashed through Lu Chen's mind.

All the medical records of this 12-bed old man flashed through Lu Chen's mind.

After just a few seconds, all the thoughts finally came together.

When Lu Chen looked at the patient again, he found something different.

…

No symptoms of the patient were found, but it was impossible for Xiao Shikang and Lu Chen to stay in the emergency department forever.

They still have many patients in the ward to deal with.

The patient can only be kept in the emergency department until his condition improves, and then transferred to the cardiology department.

Just when Xiao Shikang was about to leave the emergency department, Lu Chen unexpectedly walked back to bed No. 12.

Just as he was about to call out to Lu Chen, he directly lifted the patient's quilt, exposing the patient's abdomen.

Xiao Shikang felt a little strange and walked to Lu Chen: "What's wrong?"

Lu Chen frowned, glanced at the patient's abdomen, squatted down and looked at the urine bag, and something suddenly looked wrong on his face!

"Teacher Xiao, look at the patient's bladder..."

You can see that the patient's lower abdomen is obviously bulging without using your hands at all.

At this time, Xiao Shikang also felt something was wrong. Fan Jian beside him slapped his head and said, "Oh, I was so busy just now that I forgot to check the condition of my abdomen and only listened to my heart and lungs."

"Percuss it." Xiao Shikang's face looked a little unhappy, "Be gentle, don't burst the bladder."

At this moment, Fan Jian felt a thousand grass and mud horses running towards him.

Is your bladder so big? Why? Is there urinary retention?

He calmed down, immediately started to touch the patient's lower abdomen, and pressed it gently.

Voiced sound!

The normal percussion sound in the abdomen should be drum sound.

If it is dull, it means there is liquid inside!

Is it really urinary retention?

At the first time, Fan Jian couldn't even believe what he was touching!

"Old Xiao, this...this..."

Xiao Shikang shook his head slightly and said slowly: "I just took a look and found that there was sediment in the patient's urinary tube and the urine was turbid. Such urinary tubes are very easy to block. If he is really blocked and can't urinate, then It’s just urinary retention!”

"The patient's urine output was close to 2000ml every day in the past few days, but today it is only about 300ml. If it is really urinary retention, the patient will be suffocated!"

Although the old man on the hospital bed could not speak, he could definitely feel the discomfort caused by urinary retention!

As a result, you will have shortness of breath, sweat profusely, and your blood pressure will rise.

As the saying goes, a living person cannot suffocate to death, but if the urinary tube is blocked and the urine is not discharged, that would be terrible!

At this time, the nurse has come to perform bladder irrigation.

After flushing, it turned out that the urethra was blocked!

"Oh my God!" The little nurse opened her mouth wide.

After it was unobstructed, urine continued to drain out of the urinary catheter, and within a few seconds it was almost 500ml.

"Close the urinary catheter first," Xiao Shikang said, "and then urinate later."

If too much urine is eliminated in a short period of time, the full bladder will shrink rapidly, which may damage the bladder and lead to hematuria.

The little nurse was still frightened. She was also responsible today for not discovering the patient's urinary tube blockage in time.

Lu Chen finally breathed a sigh of relief!

The patient may have heart failure, but the heart failure is caused by holding in the urine!

Xiao Shikang whispered to Fan Jian on the side: "Old Fan, if you had opened the quilt earlier and looked at the shrunken penis, the urethra, and the abdomen, why would it be like this?"

The words are rough and the reasoning is not rough.

When the nurse heard the words "little jj", she almost couldn't hold back her laughter.

But in this situation, no one can laugh.

In less than 2 minutes, the old man's shortness of breath gradually eased and his blood pressure came down.

It's safe!

The crisis is over!

Fan Jian's back was soaked and his face was red.

He knew that if Lu Chen and Xiao Shikang hadn't discovered it in time, they would have continued to treat heart failure and continued to use diuretics...

The urine will accumulate more and more, but it is all held in the bladder, which is really fatal!

As the doctor on duty, he has an unshirkable primary responsibility.

"Old Xiao, thank you for today!" Fan Jian said solemnly, "Please give me a good rub later."

Xiao Shikang shook his head slightly, "Lu Chen noticed it first, UU Reading www.uukanshu.net If you want to thank him, thank him properly!"

Fan Jian looked at Lu Chen, who was standing aside, without concealing his gratitude, "Dr. Lu, thank you! If you have anything to do in the future, please come to me at any time."

Lu Chen smiled and said, "Teacher Fan, we know that your emergency department is too busy, so there will inevitably be oversights. We understand."

Hearing this, Fan Jian felt better.

In the profession of doctor, there can be no deviation at all.

Many details cannot be missed, otherwise, mistakes will eventually lead to big mistakes!

The patient was also very reasonable. In this short period of time, she also knew how tired the doctors were. They took great pains to treat her old man's illness and did not hold Dr. Fan Jian accountable.

But Lu Chen also knew that if others didn't pursue this kind of thing, he would remember it for the rest of his life!

I hope I won’t make the same mistake in my future career.

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